Treatment of Active Crohn's Disease in Children Using Partial Enteral Nutrition Combined with a Modified Crohn's Disease Exclusion Diet: A Pilot Prospective Cohort Trial on Clinical and Endoscopic Outcomes.

BACKGROUND: Partial enteral nutrition (PEN) coupled with the Crohn's disease (CD) exclusion diet (CDED) was shown to be effective in inducing clinical remission in paediatric CD. There are currently no robust data on the endoscopic outcomes of PEN. The aim of this study was to evaluate the clinical and endoscopic rates of remission after PEN combined with a modified CDED (mCDED) adjusted to the local cuisine in comparison with exclusive enteral nutrition (EEN) for the induction of remission. METHODS: Between June 2017 and February 2021, a prospective cohort study on children with active CD, treated with PEN + mCDED or EEN, was performed at a single tertiary centre. RESULTS: During the study period, 54 patients were screened and 15 were excluded according to the exclusion criteria, with six patients excluded in the first two days due to intolerance of the enteral formula. Fourteen patients were included in the PEN and 19 in the EEN group. They were assessed at Weeks 0, 1, 3 and 6, using clinical and laboratory parameters. Endoscopy was performed at Weeks 0 and 6. Clinical remission rates per protocol analysis were 84.6% in the PEN group and 81.3% in the EEN group (p = 0.99). At Week 6, an endoscopic response (a decline in the Simple Endoscopic Score for CD (SES-CD) > 50%) was observed in 84.6% of patients on PEN and in 68.8% on EEN treatment (p = 0.41). Endoscopic remission (SES-CD ≤ 2) was achieved in 53.8% of patients in the PEN group and in 50.0% in the EEN group (p = 0.99), while the mucosal healing rates (SES-CD = 0) were 38.5% with PEN and 43.8% with EEN (p = 0.99). A significant decline in the clinical and endoscopic activity scores was observed in both groups. CONCLUSION: Our study suggests that PEN + mCDED could be effective in inducing endoscopic remission and mucosal healing in active paediatric CD patients. Here, we present an analysis of the data from our cohort of patients and our real-world experience with PEN + mCDED.

Rapid weight loss among elite-level judo athletes: methods and nutrition in relation to competition performance.

Background: Rapid weight loss (RWL) followed by rapid weight gain (RWG) is a regular pre-competition routine in combat sports and weightlifting. With the prevalence of these sports exceeding 20% at the 2020 Tokyo Olympics, there are limited data on RWL and RWG practices and their impact on well-being and competitive success in elite-level athletes. Methods: A total of 138 elite-level female and male judokas, 7.7% of the athletes ranked as top 150 on the International Judo Federation Senior World Ranking List (WRL), completed a survey on RWL, RWG, and the consequences of these practices. Results: Our findings showed that 96% of the respondents practice RWL. The average reduced body mass percentage was 5.8 ± 2.3%. Respondents who used either of the dehydration methods - fluid restriction, sauna suit, and/or sauna/hot bath - to reduce weight were 88%, 85%, and 76%, respectively. Furthermore, 91% of the respondents reported reduced energy as a negative consequence of RWL and 21% experienced a collapse episode during the RWL period. Respondents ranked 1-20 on the WRL experienced fewer negative consequences of RWL and RWG (p = 0.002) and had more dietitian and/or medical doctor support (p = 0.040) than lower-ranked respondents. Those who started with RWL practices before the age of 16 (38%) were ranked lower on the WRL (p = 0.004) and reported more negative consequences of RWL and RWG (p = 0.014). Conclusions: This study is the first to provide insight into the RWL practices of worldwide elite-level judokas and provides valuable information for the combat sports society, especially coaches. Proper weight management and optimal timed initiation of RWL practices in a judoka's career may contribute to success at the elite level.

Sources of vitamin D for humans.

Both vitamin D insufficiency and deficiency are now well-documented worldwide in relation to human health, and this has raised interest in vitamin D research. The aim of this article is therefore to review the literature on sources of vitamin D. It can be endogenously synthesised under ultraviolet B radiation in the skin, or ingested through dietary supplements and dietary sources, which include food of animal and plant origin, as well as fortified foods. Vitamin D is mainly found in two forms, D3 (cholecalciferol) and D2 (ergocalciferol). In addition to the D3 and D2 forms of vitamin D, 25-hydroxy vitamin D also contributes significantly to dietary vitamin D intake. It is found in many animal-derived products. Fortified food can contain D3 or D2 forms or vitamin D metabolite 25-hydroxy vitamin D. Not many foods are a rich source (> 4 µg/100 g) of vitamin D (D represents D3 and/or D2), e.g., many but not all fish (5-25 µg/100 g), mushrooms (21.1-58.7 µg/100 g), Reindeer lichen (87 µg/100 g) and fish liver oils (250 µg/100 g). Other dietary sources are cheese, beef liver and eggs (1.3-2.9 µg/100 g), dark chocolate (4 µg/100 g), as well as fortified foods (milk, yoghurt, fat spreads, orange juice, breakfast grains, plant-based beverages). Since an adequate intake of vitamin D (15 µg/day set by the European Food Safety Authority) is hard to achieve through diet alone, dietary supplements of vitamin D are usually recommended. This review summarizes current knowledge about different sources of vitamin D for humans.